New research suggests that improving the quality of the average American's diet could substantially reduce the costs associated with heart disease, diabetes, cancer and other major health problems.

The study is the first to comprehensively analyze the potential cost implications of improved adherence to healthy dietary patterns as measured by the Healthy Eating Index (HEI) and the Mediterranean-style diet (MED) score among US adults across major chronic disease types. Previous research has focused on specific populations or specific conditions, such as heart disease.

"We found that increasing adherence to healthy dietary patterns by even 20 percent at a population level has the potential to save more than $20 billion in both direct and indirect costs associated with 10 major health outcomes," said lead study author Dr. Carolyn Scrafford, senior managing scientist at Exponent.

The average US adult currently scores a 3.5 out of 9 possible points on the MED score used to assess adherence to the Mediterranean-style diet. If 20% raised this adherence, the researchers project an annual savings of about $21-26 billion.

Health outcomes

The lower estimate includes only breast, colorectal and prostate cancer along with five other health outcomes (coronary heart disease, stroke, type 2 diabetes, hip fractures and Alzheimer's disease) while the higher estimate includes savings related to all cancer types along with the same five other health outcomes.

Annual savings could reach $112-135 billion if Americans increased their MED adherence to 80 percent by incorporating more components of the Mediterranean-style diet.

"Our results suggest that it's worthwhile to educate Americans on these dietary patterns and their components, to encourage them to make little changes to improve their diet quality," said Scrafford.

To estimate how the healthy US- and Mediterranean-style dietary patterns influence rates of disease among adults in the US, the researchers systematically analyzed the published scientific literature to identify recent meta-analyses assessing observed associations between specific chronic health outcomes and adherence as measured by the HEI or MED scores.

They then used the data in those studies to model the expected increase or decrease in risk of the health outcomes among healthy US adults under modeled levels of adherence to these healthy dietary patterns.

To estimate health care costs, the team used data from the American Heart Association, American Diabetes Association and National Cancer Institute of the National Institutes of Health, along with case reports tracking costs associated with hip fractures and Alzheimer's disease.

Cost estimates included both direct costs-; such as medical fees, devices, and drugs-; and indirect costs, such as lost wages and caregiver burden, where available.